| NPI | 1760620611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AK 342) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AK 1068) |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2009-03-04 |